Search

Your search keyword '"Holger Flick"' showing total 2 results
Start Over "Holger Flick" Search Limiters Available in Library Collection Journal critical care
2 results on '"Holger Flick"'

1. Multicenter evaluation of a lateral-flow device test for diagnosing invasive pulmonary aspergillosis in ICU patients

Author

Brigitte Selitsch, Susanne Eigl, Frederike Reischies, Peter Neumeister, Mark Reinwald, Birgit Willinger, Birgit Spiess, Dieter Buchheidt, Martin Hoenigl, Michael Meilinger, Juergen Prattes, Stephan Eschertzhuber, Christopher R. Thornton, Michaela Lackner, Robert Krause, Cornelia Lass-Flörl, Reinhard B. Raggam, Holger Flick, and Albert Wölfler

Subjects
Male, Critical Care and Intensive Care Medicine, Medical and Health Sciences, law.invention, chemistry.chemical_compound, 610 Medical sciences Medicine, law, 80 and over, Prospective Studies, Young adult, skin and connective tissue diseases, Prospective cohort study, Aged, 80 and over, Invasive Pulmonary Aspergillosis, screening and diagnosis, medicine.diagnostic_test, Incidence (epidemiology), Middle Aged, Intensive care unit, Intensive Care Units, Detection, Female, Infection, Bronchoalveolar Lavage Fluid, 4.2 Evaluation of markers and technologies, Adult, medicine.medical_specialty, and over, Young Adult, Galactomannan, Rare Diseases, Clinical Research, Internal medicine, medicine, Humans, Aged, business.industry, Research, Prevention, Odds ratio, bacterial infections and mycoses, Emergency & Critical Care Medicine, 4.1 Discovery and preclinical testing of markers and technologies, respiratory tract diseases, Surgery, Clinical trial, Bronchoalveolar lavage, chemistry, business
Abstract

Introduction The incidence of invasive pulmonary aspergillosis (IPA) in intensive care unit (ICU) patients is increasing, and early diagnosis of the disease and treatment with antifungal drugs is critical for patient survival. Serum biomarker tests for IPA typically give false-negative results in non-neutropenic patients, and galactomannan (GM) detection, the preferred diagnostic test for IPA using bronchoalveolar lavage (BAL), is often not readily available. Novel approaches to IPA detection in ICU patients are needed. In this multicenter study, we evaluated the performance of an Aspergillus lateral-flow device (LFD) test for BAL IPA detection in critically ill patients. Methods A total of 149 BAL samples from 133 ICU patients were included in this semiprospective study. Participating centers were the medical university hospitals of Graz, Vienna and Innsbruck in Austria and the University Hospital of Mannheim, Germany. Fungal infections were classified according to modified European Organization for Research and Treatment of Cancer/Mycoses Study Group criteria. Results Two patients (four BALs) had proven IPA, fourteen patients (sixteen BALs) had probable IPA, twenty patients (twenty-one BALs) had possible IPA and ninety-seven patients (one hundred eight BALs) did not fulfill IPA criteria. Sensitivity, specificity, negative predictive value, positive predictive value and diagnostic odds ratios for diagnosing proven and probable IPA using LFD tests of BAL were 80%, 81%, 96%, 44% and 17.6, respectively. Fungal BAL culture exhibited a sensitivity of 50% and a specificity of 85%. Conclusion LFD tests of BAL showed promising results for IPA diagnosis in ICU patients. Furthermore, the LFD test can be performed easily and provides rapid results. Therefore, it may be a reliable alternative for IPA diagnosis in ICU patients if GM results are not rapidly available. Trial registration ClinicalTrials.gov NCT02058316. Registered 20 January 2014.

Published
2015
Full Text
View/download PDF

2. Sequential organ failure assessment score is an excellent operationalization of disease severity of adult patients with hospitalized community acquired pneumonia - results from the prospective observational PROGRESS study.

Author

Ahnert, Peter, Creutz, Petra, Horn, Katrin, Schwarzenberger, Fabian, Kiehntopf, Michael, Hossain, Hamid, Bauer, Michael, Brunkhorst, Frank Martin, Reinhart, Konrad, Völker, Uwe, Chakraborty, Trinad, Witzenrath, Martin, Löffler, Markus, Suttorp, Norbert, Scholz, Markus, and PROGRESS Study Group

Abstract

Background: CAP (Community acquired pneumonia) is frequent, with a high mortality rate and a high burden on health care systems. Development of predictive biomarkers, new therapeutic concepts, and epidemiologic research require a valid, reproducible, and quantitative measure describing CAP severity.Methods: Using time series data of 1532 patients enrolled in the PROGRESS study, we compared putative measures of CAP severity for their utility as an operationalization. Comparison was based on ability to correctly identify patients with an objectively severe state of disease (death or need for intensive care with at least one of the following: substantial respiratory support, treatment with catecholamines, or dialysis). We considered IDSA/ATS minor criteria, CRB-65, CURB-65, Halm criteria, qSOFA, PSI, SCAP, SIRS-Score, SMART-COP, and SOFA.Results: SOFA significantly outperformed other scores in correctly identifying a severe state of disease at the day of enrollment (AUC = 0.948), mainly caused by higher discriminative power at higher score values. Runners-up were the sum of IDSA/ATS minor criteria (AUC = 0.916) and SCAP (AUC = 0.868). SOFA performed similarly well on subsequent study days (all AUC > 0.9) and across age groups. In univariate and multivariate analysis, age, sex, and pack-years significantly contributed to higher SOFA values whereas antibiosis before hospitalization predicted lower SOFA.Conclusions: SOFA score can serve as an excellent operationalization of CAP severity and is proposed as endpoint for biomarker and therapeutic studies.Trial Registration: clinicaltrials.gov NCT02782013 , May 25, 2016, retrospectively registered. [ABSTRACT FROM AUTHOR]

Published
2019
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results